More severely injured patients who require surgery may need blood typing or cross matching, prothrombin time, and activated partial thromboplastin time studies.

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Imaging Studies

See the list below:

The need for imaging studies is dictated by other elements of the history or by patient complaints. Violent tetanic contractions may lead to focal bone fractures; the latter can also result from falls, especially in the context of lightning injury or high-voltage DC current.

Other Tests

Diagnostic Procedures

See the list below:

The development of increased myofascial compartment pressures is of great concern. If this is suspected, each compartment must be measured. If signs and symptoms of compartment syndrome exist, decompression is necessary. The hallmark of compartment syndrome is pain with passive motion in the compartment containing the muscle groups responsible for that motion. Characteristically, the pain is unrelenting and may appear out of proportion to the visible injury. Patients may experience paresthesia, hypoesthesia, or decreased motor function. Remember that loss of pulses is a late sign of compartment syndrome.

Contact electrical burn. This was the ground of a 120-V alternating current nominal circuit. Note vesicle with surrounding erythema. Note thermal and contact electrical burns cannot be distinguished easily.

Contact electrical burns, 120-V alternating current nominal. The right knee was the energized side, and the left was ground. These are contact burns and are difficult to distinguish from thermal burns. Note entrance and exit are not viable concepts in alternating current.